下腹部手术后自控镇痛对血清补体C_3、C_4和C-反应蛋白的影响

Effects of patient-controlled epidural analgesia on serum C_3,C_4 and C-reactive protein after lower abdominal surgery

目的探讨下腹部手术后硬膜外自控镇痛(PCA)对血清补体C3、C4和C-反应蛋白(CRP)的影响。方法选择择期施行下腹部手术的患者60例,其中30例于术后行PCA(A组),另30例于术后肌内注射镇痛药止痛(B组),比较2组镇痛效果,并分别测定术前12 h及术后12 h、24 h、48 h时补体C3、C4和CRP含量。结果A组患者术后伤口疼痛明显减轻;术后12h 2组患者补体C3、C4含量均下降,术后48 h A组补体C3、C4含量回升,而B组仍处于低水平。术后12 h 2组患者CRP含量均升高,术后48 h A组CRP含量下降,而B组仍处于高水平。结论下腹部手术后施行PCA能有效地减轻术后伤口的疼痛,并能减轻应激反应所致的免疫抑制,从而保护机体的免疫功能,有利于机体的康复。

Objective It is to explore the effects of patient-controlled epidural analgesia （PCA） on the patients＇ complement C3, C4 and C - reactive protein （CRP） after lower abdominal surgery. Methods 60 patients undergoing lower abdominal surgery were chosen, in whom 30 cases （group A） were given PCA at the end of operation, the other 30 patients （group B） were given analgesic drugs by intramuscular injection. The degrees of postoperative pain in both groups were compared. The blood samples of both groups were obtained 12 h before operation, and 12 h, 24 h, 48h after surgery to determine complement C3, C4 and CRP. Results Pain was obviously relieved in the patients in group A after surgery. The levels of C3 and C4 lowed down and CRP rose up in both groups 12 h after operation. The contents of C3, C4 increased and that of CRP decreased in groupA 48 h after operation, while the indexes above in group B had no obvious change. Conclusions Postoperative pain management with PCEA can reduce wound pain effectively and reduce stress-induced immune inhibition, so to protect body immunity and is beneficial for recovery.